DOs Residency Merger with ACGME

[residency_seeker]

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Folks,
Can someone realistically tell me if the chances of DOs matching will decrease once the DOs residencies merge with MD residencies? I have heard that DOs and MDs residency programs are merging and I am scared that it will decrease the number of DOs matching now that they don't have their own DO residency programs and they will have to fight for a spot against AMG (MDs), Carribbeans (MDs) and IMGs.
Please suggest if pursuing DO at this point is still a good option and a residency is almost guaranteed considering the fact that a person scores decent in COMLEX.

 

[QualityProcess]

There isn't any evidence to suggest that it will become more difficult to match. Also, I suggest dropping the "merger" nomenclature in favor of single accreditation system.

 

[Goro]

Time will tell, but every DO colleague of mine who is well connected to AOA expect the single accreditation system to be beneficial to DO grads. In addition, IMGs, particularly those from Carib diploma mills will be squeezed out.

Folks,
Can someone realistically tell me if the chances of DOs matching will decrease once the DOs residencies merge with MD residencies? I have heard that DOs and MDs residency programs are merging and I am scared that it will decrease the number of DOs matching now that they don't have their own DO residency programs and they will have to fight for a spot against AMG (MDs), Carribbeans (MDs) and IMGs.
Please suggest if pursuing DO at this point is still a good option and a residency is almost guaranteed considering the fact that a person scores decent in COMLEX.

 

[the argus]

In addition, IMGs, particularly those from Carib diploma mills will be squeezed out.

This little tidbit is often stated on SDN, but I've yet to see anyone actually explain why this would be the case.

As of now, USMDs/DOs/IMGs apply for spots through the NRMP, and DOs have protected AOA spots that only they can apply for. The only real consequence of this merger is that now the AOA spots will be open to everyone. How can this possibly be a bad thing for IMGs? The number of spots they can apply for is increasing.

This merger has nothing to do with increasing the total number of AMG applicants, all it does is open up the previously DO protected residency positions to everyone else. DOs will not have to choose to go through the AOA match first and withdrawal from the NRMP, which is good for them, but that won't have any consequence to the number of IMGs matching as they will just then fill the previously DO-only spots.

 

[Mjolner]

This little tidbit is often stated on SDN, but I've yet to see anyone actually explain why this would be the case.

As of now, USMDs/DOs/IMGs apply for spots through the NRMP, and DOs have protected AOA spots that only they can apply for. The only real consequence of this merger is that now the AOA spots will be open to everyone. How can this possibly be a bad thing for IMGs? The number of spots they can apply for is increasing.

This merger has nothing to do with increasing the total number of AMG applicants, all it does is open up the previously DO protected residency positions to everyone else. DOs will not have to choose to go through the AOA match first and withdrawal from the NRMP, which is good for them, but that won't have any consequence to the number of IMGs matching as they will just then fill the previously DO-only spots.

Are you IMG?

 

[Mad Jack]

This little tidbit is often stated on SDN, but I've yet to see anyone actually explain why this would be the case.

As of now, USMDs/DOs/IMGs apply for spots through the NRMP, and DOs have protected AOA spots that only they can apply for. The only real consequence of this merger is that now the AOA spots will be open to everyone. How can this possibly be a bad thing for IMGs? The number of spots they can apply for is increasing.

This merger has nothing to do with increasing the total number of AMG applicants, all it does is open up the previously DO protected residency positions to everyone else. DOs will not have to choose to go through the AOA match first and withdrawal from the NRMP, which is good for them, but that won't have any consequence to the number of IMGs matching as they will just then fill the previously DO-only spots.

Traditionally osteopathic programs with largely osteopathic PDs will likely favor DOs, it's not rocket science. Programs that had previously gone unfilled will likely fill with IMGs though.

 

[Mad Jack]

Are you IMG?

He's a resident that graduated from the Carib. Ross, I believe.

 

[Mjolner]

Traditionally osteopathic programs with largely osteopathic PDs will likely favor DOs, it's not rocket science. Programs that had previously gone unfilled will likely fill with IMGs though.

Until US med school expansion causes those to be filled too.

 

[Mjolner]

He's a resident that graduated from the Carib. Ross, I believe.

Right on.

 

[the argus]

Programs that had previously gone unfilled will likely fill with IMGs though.

Exactly, so how is this merger a bad thing for IMGs?

 

[Mad Jack]

Until US med school expansion causes those to be filled too.

They still might not fill with US grads. When it comes to taking bottom of the barrel MDs and DOs with multiple red flags versus a top Carib or IMG candidate with stellar records, you're going to take the IMG.

 

[Mad Jack]

Exactly, so how is this merger a bad thing for IMGs?

It's in no way bad for IMGs, as the merger only opens up new positions that weren't open before. The merger in no way changes the basic math that's rapidly approaching of way too many schools popping up left and right that are going to flood out many IMGs within a decade or so.

 

[the argus]

It's in no way bad for IMGs, as the merger only opens up new positions that weren't open before. The merger in no way changes the basic math that's rapidly approaching of way too many schools popping up left and right that are going to flood out many IMGs within a decade or so.

Ok good, just making sure you agree that the original post I quoted is complete bull****. We're on the same page then

 

[residency_seeker]

I think that DO students will face slightly tough time in matching when their AOA programs are merged because they will have to compete with AMG MDs and IMG MDs as well. What do you guys think?

 

[hse]

I think that DO students will face slightly tough time in matching when their AOA programs are merged because they will have to compete with AMG MDs and IMG MDs as well. What do you guys think?

those programs will be run by do's. you're assuming they will rank igms higher than do's

 

[Mjolner]

those programs will be run by do's. you're assuming they will rank igms higher than do's

This is an important point that I think a lot of people overlook. These PDs either preferentially chose DO, or were DOs who felt the bias on the interview trail themselves. Either of these factors would create a pro-DO bias.

In the very short term (next 2-3 years) it will hugely benefit DOs who can do AOA residencies that will become ACGME before they finish.
In the less short term still benefits DO as the PDs will be biased.
Once there is turn over in the PDs it might hurt the DOs, but the unified training will eventually significantly help the DOs.

At least that's how I see it playing out.

 

[the argus]

This is an important point that I think a lot of people overlook. These PDs either preferentially chose DO, or were DOs who felt the bias on the interview trail themselves. Either of these factors would create a pro-DO bias.

In the very short term (next 2-3 years) it will hugely benefit DOs who can do AOA residencies that will become ACGME before they finish.
In the less short term still benefits DO as the PDs will be biased.
Once there is turn over in the PDs it might hurt the DOs, but the unified training will eventually significantly help the DOs.

At least that's how I see it playing out.

You are incredibly overestimating this mythical "DO scorn" that you assume osteopathic PDs feel. There might be a few who feel this way, but I would guess the vast majority of DO PDs just want the best residents they can get, regardless of where they come from.

Most people in the real world (i.e. not SDN) don't really care that much about the letters behind someone's name. They care about whether the person is competent or not.

 

[Mjolner]

You are incredibly overestimating this mythical "DO scorn" that you assume osteopathic PDs feel. There might be a few who feel this way, but I would guess the vast majority of DO PDs just want the best residents they can get, regardless of where they come from.

Most people in the real world (i.e. not SDN) don't really care that much about the letters behind someone's name. They care about whether the person is competent or not.

Eh. While there are still programs that openly refuse DO applicants on their websites and fields that are "closed" to DO students and the belief that taking a DO weakens the program, there will be DO PDs who prefer DOs.

 

[meliora27]

As long as Ross and SGU continue to pay some of the NY hospitals for rotation sites, I think the pipeline to residency will remain wide open. Take a look at SGU's match list, there's a handful of programs, especially in IM, where by shear numbers, SGU grads must make up 75% of the housestaff roster per year.

I think the Caribbean schools will continue to buy rotations, and vis a vis, buy residency slots.

Now I'm not sure what the caliber of these programs are however...

 

[GUH]

Eh. While there are still programs that openly refuse DO applicants on their websites and fields that are "closed" to DO students and the belief that taking a DO weakens the program, there will be DO PDs who prefer DOs.

There is a difference between preferring DOs and ONLY taking DO's.

 

[the argus]

As long as Ross and SGU continue to pay some of the NY hospitals for rotation sites, I think the pipeline to residency will remain wide open. Take a look at SGU's match list, there's a handful of programs, especially in IM, where by shear numbers, SGU grads must make up 75% of the housestaff roster per year.

I think the Caribbean schools will continue to buy rotations, and vis a vis, buy residency slots.

Now I'm not sure what the caliber of these programs are however...

Most Caribbean grads match into programs that have no affiliation with any Caribbean medical school. I'm not sure what you are insinuating. Programs are full of caribbean grads because USMD grads don't want to go there, and the hospital/PD would rather have a US citizen staffing their hospital than a foreign citizen.

Caribbean medical schools stay in business because the US medical education system (MD + DO) does not produce enough graduates on a yearly basis to fulfill the needs of the US medical residency system, plain and simple. It's currently off by >6,000 spots. You are acting like the reason these schools stay in business is because they provide money to hospitals. That's just silly and ridiculous. Caribbean medical schools stay in business because there is a need for more residents than the US education system provides.

People try to make this more complicated than it is. The US needs more doctors than it is currently producing, end of story.

 

[Mjolner]

There is a difference between preferring DOs and ONLY taking DO's.

True. But as long as there are spots in every specialty that will look at DOs as equals then we're good.

 

[Dr. Death]

Seems like a good amount of AOA residency programs will close permanently or temporarily because of an inability to meet ACGME standards by the time of the merger. Is this the case?

 

[SnowDoggy44]

I think another aspect being overlooked in this thread is that some of the previously AOA programs, residencies and fellowships, will seek "osteopathic recognition" from the ACGME Osteopathic Principles Committee meaning non-DO applicants will need to meet this additional prerequisite to be eligible: "have sufficient background and/or instruction in osteopathic philosophy and techniques in manipulative medicine sufficient to prepare them to engage in the curriculum of the program..."
This could be a difficult prerequisite to meet particularly for IMG/FMGs.

 

[NontradCA]

Basically all DOs will have to practice FM in South Dakota on uninsured patients.

 

[dfib slim]

Basically all DOs will have to practice FM in South Dakota on uninsured patients.

Joke about it now but I could see DOs getting pigeonholed into primary care in the foreseeable future.

 

[NontradCA]

Joke about it now but I could see DOs getting pigeonholed into primary care in the foreseeable future.

I mean personally, I would rather work at McDonalds.

 

[the argus]

Seems like a good amount of AOA residency programs will close permanently or temporarily because of an inability to meet ACGME standards by the time of the merger. Is this the case?

Highly unlikely. Residents, unlike medical students, have a defined and important role in the hospital. It would be very difficult for hospitals to completely replace this workforce. In more populated places it might be possible by hiring a combination of additional midlevels/attendings, but in many places there just isn't the available workforce to make this a reality.

There could be a shift in how residents are affiliated (i.e. hospital X's program closes but hospital Y increases their class size and then also covers hospital X), but it's very unlikely that the merger will result in any significant decrease in the total number of residency positions in the US. There is already a shortage of physicians being trained, and most hospitals with residents rely heavily on the (comparatively cheap) resident workforce to make the hospital run.

 

[NurWollen]

I mean personally, I would rather work at McDonalds.

Basically all DOs will have to practice FM in South Dakota on uninsured patients.

You do realize that the average FM doctor in SD probably earns upwards of twice what an FM doc in a big city would earn, right? I'd pick SD rural medicine over urban referral factory, but that's just me.

 

[Mjolner]

Highly unlikely. Residents, unlike medical students, have a defined and important role in the hospital. It would be very difficult for hospitals to completely replace this workforce. In more populated places it might be possible by hiring a combination of additional midlevels/attendings, but in many places there just isn't the available workforce to make this a reality.

There could be a shift in how residents are affiliated (i.e. hospital X's program closes but hospital Y increases their class size and then also covers hospital X), but it's very unlikely that the merger will result in any significant decrease in the total number of residency positions in the US. There is already a shortage of physicians being trained, and most hospitals with residents rely heavily on the (comparatively cheap) resident workforce to make the hospital run.

Agreed.

 

[Noomm]

One thing is clear to me: OMM will soon become a thing of the past. Do you really think that the ACGME is going to stand for OMM fellowships? I doubt it.

 

[IslandStyle808]

One thing is clear to me: OMM will soon become a thing of the past. Do you really think that the ACGME is going to stand for OMM fellowships? I doubt it.

Residency maybe, but fellowships are not an issue. There are fellowship not accredited by the ACGME anyway. If this happened, then the fellowships would just be unaccredited.

 

[BGMayagi]

I was working at the hospital last night and had some free time. I looked up residency programs and they all said they were applying accredition for an Osteopathic Focused Track for the soon to be acgme accredited programs(IM, Surg, IM NMM, psych). From what it looks like, the prev. AOA programs are still going to be very DO friendly with terms like that. Im not sure if its the same elsewhere but wanted to share that info about one hosp.

 

[GUH]

I think another aspect being overlooked in this thread is that some of the previously AOA programs, residencies and fellowships, will seek "osteopathic recognition" from the ACGME Osteopathic Principles Committee meaning non-DO applicants will need to meet this additional prerequisite to be eligible: "have sufficient background and/or instruction in osteopathic philosophy and techniques in manipulative medicine sufficient to prepare them to engage in the curriculum of the program..."
This could be a difficult prerequisite to meet particularly for IMG/FMGs.

That requirement is quite vague and does not explicitly exclude the possibility of a one-week crash course in OMT to give a "sufficient" background" (whatever that means) to any applicant. Note that it does not even mention basic competency in palpation or other aspects of osteopathic diagnosis.

 

[deleted564680]

There was also a stipulation that all ACGME residency programs had to have a PD that was trained in an ACGME program. This would include AOA programs...For example, a DO program director in an AOA orthopedic surgery program => becomes ACGME after merger => DO PD has to step down in favor of an MD that did an ACGME residency since very few DOs did an orthopedic surgery ACGME residency. Now that the former AOA program has an MD PD, I'm sure it will fill with MDs and continue the bias toward DOs just like all the other MD programs. To be honest, I'm not sure if they have rectified this provision or not.

The reason the ACGME wanted to merge was to gain all of the DOs so they could be filling the primary care slots. The future will be MD = specialties and DO = primary care.

 

[Mjolner]

There was also a stipulation that all ACGME residency programs had to have a PD that was trained in an ACGME program. This would include AOA programs...For example, a DO program director in an AOA orthopedic surgery program => becomes ACGME after merger => DO PD has to step down in favor of an MD that did an ACGME residency since very few DOs did an orthopedic surgery ACGME residency. Now that the former AOA program has an MD PD, I'm sure it will fill with MDs and continue the bias toward DOs just like all the other MD programs. To be honest, I'm not sure if they have rectified this provision or not.

The reason the ACGME wanted to merge was to gain all of the DOs so they could be filling the primary care slots. The future will be MD = specialties and DO = primary care.

I would assume that the AOA would get them grandfathered in before the merger takes effect.

 

[hallowmann]

Residency maybe, but fellowships are not an issue. There are fellowship not accredited by the ACGME anyway. If this happened, then the fellowships would just be unaccredited.

Exactly. There's fellowships in a ton of topics, and many are also ACGME accredited. The fact that the ACGME has created committees dedicated to NMM/OMM, makes it sure seem like it's being taken seriously by them. Even if it wasn't, it would just work out the way you described.

That requirement is quite vague and does not explicitly exclude the possibility of a one-week crash course in OMT to give a "sufficient" background" (whatever that means) to any applicant. Note that it does not even mention basic competency in palpation or other aspects of osteopathic diagnosis.

I think it'll more likely be a 1 month rotation/workshop or a summer crash course between 1st and 2nd year.

That all said, the requirement was made purposefully vague to accommodate different levels of proficiency required in each specialty. OMM in an FM program will be very different than OMM in a Rads program.

There was also a stipulation that all ACGME residency programs had to have a PD that was trained in an ACGME program. This would include AOA programs...For example, a DO program director in an AOA orthopedic surgery program => becomes ACGME after merger => DO PD has to step down in favor of an MD that did an ACGME residency since very few DOs did an orthopedic surgery ACGME residency. Now that the former AOA program has an MD PD, I'm sure it will fill with MDs and continue the bias toward DOs just like all the other MD programs. To be honest, I'm not sure if they have rectified this provision or not.

The reason the ACGME wanted to merge was to gain all of the DOs so they could be filling the primary care slots. The future will be MD = specialties and DO = primary care.

You are mistaken.

This has already been addressed. RCs of all but 3 specialties have agreed to accept AOA-boarded DOs as equivalent and meeting the PD requirement. So basically 97% of PDs don't have to worry at all about what you talked about. The remaining 3% of programs in Uro and I forget the other 2 (other surgeries, but not Ortho) could potentially need to hire another PD.

 

[MrChance2]

The reason the ACGME wanted to merge was to gain all of the DOs so they could be filling the primary care slots. The future will be MD = specialties and DO = primary care."

I generally agree with this. I think most people reading this will have matched by the time it really changes.

Re: Goro, I don't understand how FMGs being able to match previously DO only slots is a bad thing for them. I could see them get squeezed out soon though just because of all the US MD and DO schools opening up though.

 

[TopTomato]

This has already been addressed. RCs of all but 2 specialties have agreed to accept AOA-boarded DOs as equivalent and meeting the PD requirement. So basically 97% of PDs don't have to worry at all about what you talked about. The remaining 3% of programs in Uro and I forget the other one (another surgery, but not Ortho) could potentially need to hire another PD.

It's neurosurgery

https://www.acgme.org/acgmeweb/Portals/0/PDFs/Nasca-Community/PD_Qualifications_forWeb.pdf

 

[hallowmann]

The reason the ACGME wanted to merge was to gain all of the DOs so they could be filling the primary care slots. The future will be MD = specialties and DO = primary care."

I generally agree with this. I think most people reading this will have matched by the time it really changes.

Re: Goro, I don't understand how FMGs being able to match previously DO only slots is a bad thing for them. I could see them get squeezed out soon though just because of all the US MD and DO schools opening up though.

You're making plenty of assumptions. What reason do you have to think DOs wouldn't match into specialties? DOs regularly match into ACGME specialties as it is. There alway are 55-60% of DOs that compete with MDs for ACGME programs every year. Many of those are in specialties. Path for example is certainly not primary care, and there are plenty of DOs matching path, which is already exclusively ACGME.

I might see your point in saying that less DOs will match Plastics, NS, and ENT, but strictly matching PC only and no specialties is kind of a ridiculous claim.

In terms of IMGs, the only guess I would have is that many IMGs will be competing with another 2000-3000 DOs. That said, there will also be 2500 more spots or sos. To say that IMGs will really benefit though is an overestimation of what they may get from this. There really isn't an appreciable amount of empty AOA seats at the end of the match to make any sort of overall difference for IMGs. Afterall, only 300-600 residencies are open after the match, and most are filled by the end of March due to the scramble. To give you an idea, there are 6000 US-IMGs & 12000 non-US IMGs every year applying for a spot (and that number is constantly increasing), and half don't get a spot.

It's neurosurgery

https://www.acgme.org/acgmeweb/Portals/0/PDFs/Nasca-Community/PD_Qualifications_forWeb.pdf

Yup, I finally found the source, and its actually 3 programs. It's Uro, NS and ENT. Kind of telling that those 3 specialties make up only 3% of all AOA programs and probably a smaller yet percentage of seats.

 

[TopTomato]

You making plenty of assumptions. What reason do you have to think DOs wouldn't match into specialties? DOs regularly match into ACGME specialties as it is. There alway are 55-60% of DOs that compete with MDs for ACGME programs every year. Many of those are in specialties. Path for example is certainly not primary care, and there are plenty of DOs matching path, which is already exclusively ACGME.

I might see your point in saying that less DOs will match Plastics, NS, and ENT, but strictly matching PC only and no specialties is kind of a ridiculous claim.

In terms of IMGs, the only guess I would have is that many IMGs will be competing with another 2000-3000 DOs. That said, there will also be 2500 more spots or sos. To say that IMGs will really benefit though is an overestimation of what they may get from this. There really isn't an appreciable amount of empty AOA seats at the end of the match to make any sort of overall difference for IMGs. Afterall, only 300-600 residencies are open after the match, and most are filled by the end of March due to the scramble. To give you an idea, there are 6000 US-IMGs & 12000 non-US IMGs every year applying for a spot (and that number is constantly increasing), and half don't get a spot.



Yup, I finally found the source, and its actually 3 programs. It's Uro, NS and ENT. Kind of telling that those 3 specialties make up only 3% of all AOA programs and probably a smaller yet percentage of seats.

What source do you have about ENT? The link I posted has ENT as checked off for the "will consider AOA board certification", leaving Uro and NS the last 2 hold outs. Says it was updated 8/13/2015 too

 

[burritowithgreensauce]

i read this thread out of genuine curiosity. it was nothin but typical sdn fear mongering and useless information. please state facts and stop the speculation. makes reading threads useless

 

[iwillnevergiveup]

DOs were able to match into ACGME for years...only fair that it works the other way. I welcome this parity.

 

[Goro]

That's happening now. About 2/3rds of DO grads go into Primary Care. Someone has to do it. My students actually self-select for this. I wish you guys would stop making it out to be the 7th Circle of Hell. It's not.

This is all part of an evolution where Osteopathic and Allopathic medicine will merge. Remember, at one time Surgeons were not considered Physicians, something still incorporated into the name of Columbia's med school. American medicine has come a long way from the days where AT Still (an MD, BTW) felt obligated to design a new doctrine on the practice of medicine.

Joke about it now but I could see DOs getting pigeonholed into primary care in the foreseeable future.

 

[yanks26dmb]

That's happening now. About 2/3rds of DO grads go into Primary Care. Someone has to do it. My students actually self-select for this. I wish you guys would stop making it out to be the 7th Circle of Hell. It's not.

This is all part of an evolution where Osteopathic and Allopathic medicine will merge. Remember, at one time Surgeons were not considered Physicians, something still incorporated into the name of Columbia's med school. American medicine has come a long way from the days where AT Still (an MD, BTW) felt obligated to design a new doctrine on the practice of medicine.

Do you think those of us who DON'T want to go to FM, Psych, IM are going to essentially be stuck there in about 3-4 years?

...provided we don't bomb step/comlex...

 

[Goro]

Nope.

Do you think those of us who DON'T want to go to FM, Psych, IM are going to essentially be stuck there in about 3-4 years?

...provided we don't bomb step/comlex...

 

[Seth Joo]

You're making plenty of assumptions. What reason do you have to think DOs wouldn't match into specialties? DOs regularly match into ACGME specialties as it is. There alway are 55-60% of DOs that compete with MDs for ACGME programs every year. Many of those are in specialties. Path for example is certainly not primary care, and there are plenty of DOs matching path, which is already exclusively ACGME.

I might see your point in saying that less DOs will match Plastics, NS, and ENT, but strictly matching PC only and no specialties is kind of a ridiculous claim.

In terms of IMGs, the only guess I would have is that many IMGs will be competing with another 2000-3000 DOs. That said, there will also be 2500 more spots or sos. To say that IMGs will really benefit though is an overestimation of what they may get from this. There really isn't an appreciable amount of empty AOA seats at the end of the match to make any sort of overall difference for IMGs. Afterall, only 300-600 residencies are open after the match, and most are filled by the end of March due to the scramble. To give you an idea, there are 6000 US-IMGs & 12000 non-US IMGs every year applying for a spot (and that number is constantly increasing), and half don't get a spot.



Yup, I finally found the source, and its actually 3 programs. It's Uro, NS and ENT. Kind of telling that those 3 specialties make up only 3% of all AOA programs and probably a smaller yet percentage of seats.

Not all DOs will wind up in primary care but at most schools usually around 60 percent or more of each graduating class goes into a primary care residency. Some schools encourage their students to become primary care physicians, others like mine encourage students to follow any field they desire.

 

[NurWollen]

A good number of primary care matches are in IM and peds. Some of those people will probably subspecialize, but even if they don't, a good number will end up being hospitalists, which isn't usually considered primary care. Also, a lot of not terribly competitive specialties aren't primary care. I think more DOs are going into anesthesia and rads than before, and it doesn't seem like the number of DOs going in to EM has taken much of a hit. There's also neuro (which has several subspecialties of its own), PM&R, preventative medicine, path, psych, OB/Gyn (kinda sorta primary care but it depends on practice type). Also a >>0 number of DOs are in surgery.

There will probably always be a greater proportion DOs entering primary care than MDs, but the proportion of DOs entering subspecialties is never going to be equal to or near zero.

 

[Drrrrrr. Celty]

Not all DOs will wind up in primary care but at most schools usually around 60 percent or more of each graduating class goes into a primary care residency. Some schools encourage their students to become primary care physicians, others like mine encourage students to follow any field they desire.

My school encourages people to go into what specialty they are interested in and even has tracks for people who want to do certain fields. That being said the majority end up in Primary Care and when I ask people what they want to do it's almost always peds, medicine, or fm. I mean I honestly think I want to do a non GI or Cards IM fellowship or Psych. Nothing is going to make me want to do surgery, radiology, or derm tbh.

 

[Drrrrrr. Celty]

A good number of primary care matches are in IM and peds. Some of those people will probably subspecialize, but even if they don't, a good number will end up being hospitalists, which isn't usually considered primary care. Also, a lot of not terribly competitive specialties aren't primary care. I think more DOs are going into anesthesia and rads than before, and it doesn't seem like the number of DOs going in to EM has taken much of a hit. There's also neuro (which has several subspecialties of its own), PM&R, preventative medicine, path, psych, OB/Gyn (kinda sorta primary care but it depends on practice type). Also a >>0 number of DOs are in surgery.

There will probably always be a greater proportion DOs entering primary care than MDs, but the proportion of DOs entering subspecialties is never going to be equal to or near zero.

Exactly, there are plenty of residencies that are very DO friendly. Neurology, Psych, PMR, Gas, EM, OB/Gyn, etc. It's not like people are choosing FM at the end of a spike, they're doing over a lot of other specialties that aren't anymore competitive than FM.